– PERFORMANCE MEASURES –
Institute for Healthcare Improvement (IHI)

The 100,000 Lives Campaign is an initative of the Institute for Healthcare Improvement under the leadership of Donald M. Berwick, MD CCP. The Institute for Healthcare Improvement (IHI) is a non-for-profit organization that was founded in 1991 and is based in Cambridge, Massachusetts. The IHI has a record of improvement in healthcare via IHI collaboratives and other attempts to engage providers of healthcare at the bedside.

The IHI 100,000 Lives Campaign began in January 2005 and continues through 2006. The Initiative includes six major interventions that contain 30 measures addressing

Over 3,200 hospitals have enrolled in the IHI 100,00 Lives Campaign since its inception. The IHI claimed on June 14, 2006 to have saved 122,300 Lives in over 3,100 participating hospitals.

100,000 Lives Campaign: Six Interventions

#    NQF ID		Source	Description
RAPID RESPONSE TEAMS
–	–	–	NO MEASURES REQUIRED
ADVERSE DRUG EVENTS (ADE) – Medication Reconciliation
1.	–	IHI	Percent of Unreconciled Medications, tabulated monthly (Definition left to participating hospitals)
2.	–	IHI	Unreconciled Medications per 100 Admissions, tabulated monthly (Definition left to participating hospitals)
ACUTE MYOCARDIAL INFARCTION (AMI)
1.	HC1	CMS-QIOs and JCAHO	Percent AMI patients who received ASA within 24 hours before or after hospital arrival
2.	HC2	CMS-QIOs and JCAHO	Percent AMI patients prescribed ASA at discharge
3.	HC3	CMS-QIOs and JCAHO	Percent of AMI patients who received beta-blockers within 24 hours after hospital arrival
4.	HC4	CMS-QIOs and JCAHO	Percent of AMI patients prescribed beta-blocker at discharge
5.	HC6	CMS-QIOs and JCAHO	Percent of AMI who were prescribed for ACEI or ARB at discharge for systolic dysfunction
6.	HC7	CMS-QIOs	Percent of AMI patients who received either thrombolytics within 30 minutes of hospital arrival or Percutaneous Coronary Intervention (PCI) within 120 minutes of hospital arrival
7.	HC8	CMS-QIOs	Percent of AMI patients who received thrombolytic agent within 30 minutes of hospital arrival
8.	HC33	CMS-QIOs and JCAHO	Percent of AMI patients (cigarette smokers) who received smoking cessation advice or counseling during hospital stay
9.	–	IHI	Percent of AMI patients receiving "perfect" care (receiving all 7 of preceding measures)
10.	–	IHI	AMI Inpatient Mortality (self-reported)
SURGICAL SITE INFECTION (SSI)
1.	HC36	SCIP Inf1	Percent of Surgical Patients with Timely Prophylactic Antibiotic Administration
2.	HC37	SCIP Inf2	Percent of Surgical Patients with Appropriate Selection of Prophylactic Antibiotic
3.	HC38	SCIP Inf3	Percent of Surgical Patients with Appropriate Prophylactic Antibiotic Discontinuation
4.	–	SCIP Inf4	Percent of Major Cardiac Surgical Patients with Controlled Post Operative Serum Glucose
5.	–	SCIP Inf6	Percent of Surgical Patients with Appropriate Hair Removal
6.	–	SCIP Inf7	Percent of Colorectal Surgical Patients with Normothermia in PACU
7.	–	NNIS	Percent of Clean Surgery Patients with Surgical Infection
PREVENT CENTRAL LINE INFECTIONS
1.	–	JCAHO ICU4	Central Line-Associated Primary Bloodstream Infection (BSI) Rate per 1000 Central Line-Days
2.	–	IHI	Central Line Bundle Compliance. The percentage of intensive care patients in the included ICUs with central lines for whom all five elements of the central line "bundle" are documented on the daily goals sheet and/or central line checklist or patient's medical record. The central line bundle elements include: • Hand hygiene • Maximal barrier precautions upon insertion • Chlorhexidine skin antisepsis • Optimal catheter site selection, with subclavian vein as the preferred site for non-tunneled catheters in patients 18 years and older • Daily review of line necessity with prompt removal of unnecessary lines
VENTILATORY ASSOCIATED PNEUMONIA (VAP)
1.	–	CDC	Ventilator-Associated Pneumonia (VAP) Rate in ICU per 1000 Ventilator Days
2.	–	IHI	Ventilatory Bundle Compliance. The percentage of intensive care patients on mechanical ventilation for whom all four elements of the ventilator "bundle" are implemented and documented on the daily goals sheet and/or elsewhere in medical record. The ventilator "bundle" includes:
	–	JCAHO ICU-1	• Head of bed elevation 30 degrees or greater
	–	IHI	• Daily "sedative interruption" and daily assessment of readiness to extubate
	–	JCAHO ICU-2	• PUD (peptic ulcer disease) prophylaxis
	–	JCAHO ICU-3	• DVT (deep venous thrombosis) prophylaxis